Nigeria has the highest TB burden in Africa and is 4th among the 22 countries with high TB burden globally.

Nigeria has the highest TB burden in Africa and is 4th among the 22 countries with high TB burden globally. Estimated incidence for all cases is 311per 100,000 pop (460,000) and estimated incidence for smear positive (SM+) cases is 131 per 100,000 pop (195,000).
It has an estimated TB prevalence of 521/100,000 (772,000) and estimated Mortality rate of 93/100,000 (138,000). The estimated prevalence of MDR-TB among new TB cases is 1.8% and 9.4% among previously treated TB with a prevalence of HIV in adult TB patients (15-49yrs) 27%.
The Nigerian government formally launched its National TB and Leprosy Control
Programme (NTBLCP) in 1991 and adopted the World Health Organization (WHO)–recommended
DOTS strategy in 1993. Although detection of smear-positive TB cases has tripled
over the past eight years, the overall case detection rate of 27 percent is far short of the WHO target of 70 percent. And while the treatment success rate hovered between 71 and 74 percent from 1996 to 2002—slightly below the global target of 85 percent—the latest annual treatment success rate was only 59 percent.

The NTBLCP provides technical and strategic support for TB control activities to
Nigeria’s 36 autonomous states and this include effective and systematic data collection.
However, planning and implementation of TB services is largely decentralized to highly
autonomous State TB and Leprosy Control Officers (STBLCOs) and Regional National TB
Professional Officers. NTBLP efforts to raise awareness about TB and the requirements of the DOTS strategy and to increase political commitment to high-quality TB control programming must therefore focus on the state level as much as on the federal government.

Due to past patterns of donor involvement, states in the north still have far fewer
TB services than those in the south. Donors, the NTBLCP, and regional and state officials must devote particular attention to expanding TB control activities in the northern states. In addition, states must develop targeted services to address the higher concentrations of TB among vulnerable groups, including the urban poor, people living in remote areas, prisoners, migrant laborers, and people living with HIV.